A prospective, controlled analysis of endoscopic cytotechniques for diagnosis of malignant biliary strictures.
A prospective, controlled analysis of endoscopic cytotechniques for diagnosis of malignant biliary strictures.
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内窥镜细胞技术诊断恶性胆管狭窄的前瞻性对照分析。
DOI：
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发表时间：
1991
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影响因子：
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通讯作者：
T. Kummet
中科院分区：
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作者：
P. Foutch;D. Kerr;J. Harlan;T. Kummet
我们前瞻性收集了30例胆管狭窄患者（17例恶性，13例良性）的刷检液和胆汁进行细胞学检查，这些患者均通过内镜逆行胆管造影术进行评估。适当时，还对从使用这些器械治疗的个体中取出的支架上的细胞碎片进行恶性细胞评价。我们的目的是评估这些内镜细胞技术的价值，使阻塞性胆道癌的诊断。累计获得78份标本。总体而言，与胆汁（6%）结果相比，支架（36%）和刷片细胞学（33%）的灵敏度最高。如果将所有方法的结果结合起来，47%的癌症患者（17例中的8例）可以通过一种或多种细胞学技术进行诊断。无假阳性结果（特异性，100%）。我们的研究结果表明，刷片细胞学和支架细胞学在检测癌症方面几乎等同，但由于诊断延迟到内假体取出（平均3.4个月），因此刷片技术是首选。胆汁细胞学检查结果不佳。这些细胞技术的特异性很高，因此，任何方法的阳性结果都是癌症的充分证据，其他侵入性诊断程序是不必要的。
We prospectively collected brushings and bile for cytology in 30 consecutive patients with bile duct strictures (17 malignant, 13 benign) who were assessed by endoscopic retrograde cholangiography. When appropriate, the cellular debris on stents that were removed from individuals who were managed with these devices was evaluated for malignant cells as well. Our aim was to assess the value of these endoscopic cytotechniques for making a diagnosis of obstructing cancer of the biliary tract. A cumulative total of 78 specimens were obtained. Overall, sensitivity was highest for stent (36%) and brush (33%) cytology, compared with results obtained from bile (6%). If the results for all methods are combined, 47% of patients with cancer (eight of 17) could be diagnosed by one or more cytological technique. There were no false-positive results (specificity, 100%). Our results show that brush and stent cytology are nearly equivalent for detecting cancer, but because a diagnosis is delayed until the endoprosthesis is removed (mean 3.4 months), the brush technique is preferred. Results for bile cytology are marginal. Specificity for these cytotechniques is high; therefore, a positive result by any method is sufficient evidence for cancer, and other invasive diagnostic procedures are unnecessary.